| NPI | 1265290126 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIMALE ABDI MOHAMED Owner 763-331-2274 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2024-03-06 |
| Last Update Date | 2024-03-06 |